Provider Demographics
NPI:1477820868
Name:BELLO, YVONNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:
Last Name:BELLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SURREY LN
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-2536
Mailing Address - Country:US
Mailing Address - Phone:631-874-8592
Mailing Address - Fax:631-909-2445
Practice Address - Street 1:3 SURREY LN
Practice Address - Street 2:
Practice Address - City:MANORVILLE
Practice Address - State:NY
Practice Address - Zip Code:11949-2536
Practice Address - Country:US
Practice Address - Phone:631-874-8592
Practice Address - Fax:631-909-2445
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY542824163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMEDICAIDMedicaid
NYUPINMedicare UPIN